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Amodio E, Pizzo S, Vella G, De Francisci V, Distefano SA, Giambelluca E, Graceffa D, Verso MG, Piro E, Giuffrè M, Giammanco GM, Calamusa G. Increase of multidrug-resistant bacteria after the COVID-19 pandemic in a major teaching Hospital in Sicily (2018-2021). Int J Antimicrob Agents 2024:107123. [PMID: 38408493 DOI: 10.1016/j.ijantimicag.2024.107123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has further highlighted the continuing threat of antimicrobial resistance (AMR) to global health and economic development. In the last two decades, AMR has raised increasing concern with an estimated 4.95 million deaths globally due to bacterial AMR in 2019 alone. This study aims to analyze the impact of the pandemic on the spread of multi-drug resistant organisms (MDROs) using data from the Hospital «P. Giaccone» in Palermo, comparing pre-pandemic and pandemic periods. METHODS This observational study involved adult patients discharged from the hospital between 01/01/2018-31/12/2021. Hospital Discharge Cards were linked with microbiological laboratory reports to assess MDRO isolations. SARS-CoV-2 positivity during hospitalization was evaluated using the National Institute of Health's surveillance system. RESULTS This study evaluated 58,427 hospitalizations, where half of the patients were over 65 years old (N=26,984) and most admissions were in the medical area (N=31,716). During the hospitalization period, the isolated MDRO were 2,681(5%), whereas there were 946 subjects (2%) positive for SARS-CoV-2. In the multivariable analyses, during 2020 and 2021 there was a significant increased risk of isolation of Staphylococcus aureus,Acinetobacter baumannii,and Klebsiella pneumoniae. Age, weight of the Diagnosis Related Group (DRG), wards with higher intensity of care, and length-of-stay were associated to a higher risk of MDRO isolation. CONCLUSION Our study provides new insights into the impact of the COVID-19 pandemic on MDRO isolation and has important implications for infection control and prevention efforts in healthcare facilities. Age, DRG-weight, and longer hospital stays further increase the risk of MDRO isolation. Thus, it is imperative to improve and follow hospital protocols to prevent healthcare-associated infections.
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Affiliation(s)
- Emanuele Amodio
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Stefano Pizzo
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Giuseppe Vella
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Valerio De Francisci
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Salvatore Antonino Distefano
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Eliana Giambelluca
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Domenico Graceffa
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Maria Gabriella Verso
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Ettore Piro
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Mario Giuffrè
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Giovanni Maurizio Giammanco
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy
| | - Giuseppe Calamusa
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties «G. D'Alessandro», Via del Vespro 133, 90127, Palermo, Italy.
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Lamberti A, Lora V, Graceffa D, Bonifati C, Cota C. Nail psoriasis: a rare mRNA COVID-19 vaccine reaction. J Eur Acad Dermatol Venereol 2022; 36:e745-e746. [PMID: 35604041 PMCID: PMC9348061 DOI: 10.1111/jdv.18255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/18/2022] [Indexed: 12/16/2022]
Affiliation(s)
- A. Lamberti
- Dermatopathology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly,Dermatology Unit, Department of Medical, Surgical and neurological SciencesUniversity of SienaSienaItaly
| | - V. Lora
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - D. Graceffa
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - C. Bonifati
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - C. Cota
- Dermatopathology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
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Chimenti MS, Galluzzo M, Talamonti M, Campanati A, Bonifati C, Bruni P, Caldarola G, Carpentieri A, Chiricozzi A, De Simone C, Diotallevi F, Esposito M, Fiorella C, Graceffa D, Loconsole F, Hansel K, Mugheddu C, Papini M, Richetta A, Bergamini A, Luchetti MM, Atzori L, Peris K, Offidani A, Stingeni L, Bianchi L. AB0915 GUSELKUMAB REAL WORD DATA: EFFICACY AND SAFETY IN A COHORT OF 69 PATIENTS WITH PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriasis (PSO) is a systemic immune-mediated disorder, characterized by inflammation skin and joint manifestations: it is known that up to 30% of PsO patients develop PsA.PsO and PsA share common etiopathogenetic pathways, as IL-23/IL-17 axis. In Italy, Guselkumab (GUS), a selective IL-23 inhibitor, was approved in 2018 for the treatment of PsO, and recently it was also approved for PsA therapy. Today, there are few “real-world” studies regarding the use of GUS in PsA patients.ObjectivesA multicenter Italian study group of dermatologists and rheumatologists aimed at evaluate GUS efficacy and safety in patients with concomitant PsO and PsA in real word setting on both skin and joint domains.MethodsAn observational retrospective, multicentric study was performed in 69 PsO patients with a confirmed diagnosis of moderate to severe PsA. PASI and DLQI were used for the evaluation of skin response, and the number swollen/tender joints, presence or absence of dactylitis or enthesitis or axial involvement and painVAS were evaluated for the articular and periarticular efficacy. These analyses were performed at baseline T0 (beginning of the therapy), T1 (12 weeks) and T2 (24 weeks).Results38/69 patients (55,1%) presented oligoarthritis, 31/69 (44,9%) showed polyarthritis, none of the patients had enthesitis or axial involvement. Moreover, co-morbidities were diagnosed: hypertension (52,2%), hypercholesterolemia (34,8%), Hypertriglyceridemia (29%), diabetes (24,6%), obesity (23,2%), HIV-positive (20,3%), psychiatric disorders (17,4%), cardiopathies (15,9%), inflammatory bowel disease (7,3%), Latent Tubercolosis (4,4%), Chronic B-Hepatitis (2,9%), Chronic C-Hepatitis (1,5%). In all these patients, skin and joint responses were evaluated at week 12 and week 24.Concerning skin efficacy, PASI 90 was achieved at week 24. Concerning Joint response: painVAS progressively improved till T2, tender joint count decreased in patients with oligo and polyarthritis at T1 and maintained at T2, while swollen joint count decreased in polyarthritis patients at T1 and maintained at T2. In oligo-arthritis patients, this parameter was not improved. The number of dactylitis did not decrease during the period of study (see Table 1). No safety concerns were reported in this population.ConclusionEfficacy and safety of GUS was confirmed in this study group of PsO patients with concomitant PsA and several comorbidities in a real-life setting.Disclosure of InterestsNone declared
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Cristaudo A, Graceffa D, Pimpinelli F, Sperati F, Spoletini G, Bonifati C, Pellini R, Lora V, Pontone M, Di Bella O, Bracco D, Morrone A. Immunogenicity and safety of anti-SARS-CoV-2 BNT162b2 vaccine in psoriasis patients treated with biologic drugs. J Eur Acad Dermatol Venereol 2021; 36:e266-e268. [PMID: 34897821 DOI: 10.1111/jdv.17861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 02/02/2023]
Affiliation(s)
- A Cristaudo
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - D Graceffa
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - F Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - F Sperati
- Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - G Spoletini
- General Surgery and Liver Transplantation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Bonifati
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - R Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - V Lora
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - M Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - O Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - D Bracco
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Morrone
- Scientific Direction, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Graceffa D, Lora V, Cristaudo A, Elia F, Morrone A, Bonifati C. AB0563 DISCONTINUATION OF ANTI-TNFα IN PATIENTS WITH PSORIATIC ARTHRITIS: A SINGLE-CENTER EXPERIENCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:TNF inhibitors have been largely demonstrated to be effective and reasonably safe for the treatment of psoriatic arthritis (PsA). Current EULAR guidelines recommend the use of an anti-TNF as first choice treatment in patients with PsA for whom a synthetic DMARD (usually methotrexate or leflunomide) is not efficacious or not well tolerated [1]. In a scenario where biologic treatments are easily available, and the treat to target strategy is widely accepted, a complete disease remission or at least a minimal disease activity are considered realistic goals to be achieved in a growing proportion of patients [2]. However, there remains very little research regarding anti-TNF discontinuation in patients who achieved a complete remission [3-5].Objectives:The primary aim of this study was to measure the disease-free interval after anti-TNF discontinuation, secondary it was investigated whether the use of Power Doppler Ultrasound (PDUS) and Contrast Enhanced Ultrasound (CEUS) could improve the diagnostic accuracy in the recognition of the relapse. Finally, we wanted to characterize the clinical features of the disease recurrence.Methods:From June 2018, 35 patients with PsA (27 males and 8 female) treated with anti-TNF, in stable remission were prospectively monitored for 1 year after treatment discontinuation. Remission was defined as documented absence of clinical and ultrasonographic signs of arthritis or enthesitis. Complete rheumatological and dermatological examinations were performed in all participants, at baseline and every 8-12 weeks: American College of Rheumatology (ACR) 66-68 joint count; Psoriasis Area Severity Index (PASI); patient pain visual analog score (VAS); patient global disease activity VAS; Health Assessment Questionnaire (HAQ); Leeds Enthesitis Index (LEI); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Bath Ankylosing Spondylitis Functional Index (BASFI); Power Doppler Ultrasound (PDUS) of the involved joints and entheses, Contrast Enhanced Ultrasound (CEUS) of a selected joint or enthesis and laboratory inflammation tests.Results:31 out of the 35 enrolled patients, experienced a disease recurrence with an average disease-free interval of 27.9±21.1 weeks (Figure 1). In 3 patients the treatment was restored for a relapse of the skin psoriasis, 8 patients reported only axial symptoms of disease relapse and 20 patients had both axial and peripheral joints involvement (average DAPSA score of 23.6±11.1; average BASDAI score of 4.7±2.6; average BASFI score 4.5±2.9). In all cases the disease flare was moderate and all patients promptly regained remission after restarting the treatment. Both PDUS and CEUS were safe and reliable showing a good percentage of accordance (95,4%) in detecting synovitis and enthesitis.Conclusion:The rate of disease relapse of PsA after anti-TNF discontinuation is relevant. However the disease-free interval was not short. Retreatment with the same anti-TNF was effective and safe.References:[1]Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-712.[2]Dures E, Shepperd S, Mukherjee S, et al. Treat-to-target in PsA: methods and necessity. RMD Open. 2020 Feb;6(1):e001083.[3]Stober C, Ye W, Guruparan T, et al. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford). 2018 Jan 1;57(1):158-163.[4]Huynh DH, Boyd TA, Etzel CJ, et al. Persistence of low disease activity after tumour necrosis factor inhibitor (TNFi) discontinuation in patients with psoriatic arthritis. RMD Open. 2017 Jan 16;3(1):e000395.[5]Ye W, Tucker LJ, Coates LC. Tapering and Discontinuation of Biologics in Patients with Psoriatic Arthritis with Low Disease Activity. Drugs. 2018 Nov;78(16):1705-1715.Disclosure of Interests:None declared.
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Bonifati C, De Felice C, Lora V, Morrone A, Graceffa D. Effectiveness of etanercept biosimilar SB4 in maintaining low disease activity in patients with psoriatic arthritis switched from etanercept originator: an open-label one year study. J DERMATOL TREAT 2019; 31:687-691. [DOI: 10.1080/09546634.2019.1606886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- C. Bonifati
- Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - C. De Felice
- Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - V. Lora
- Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - A. Morrone
- Scientific Direction, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - D. Graceffa
- Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Solivetti FM, Guerrisi A, Salducca N, Desiderio F, Graceffa D, Capodieci G, Romeo P, Sperduti I, Canitano S. Appropriateness of knee MRI prescriptions: clinical, economic and technical issues. Radiol Med 2015; 121:315-22. [DOI: 10.1007/s11547-015-0606-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/09/2015] [Indexed: 10/22/2022]
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Graceffa D, Maiani E, Sperduti I, Ceralli F, Bonifati C. Clinical remission of psoriatic arthritis in patients receiving continuous biological therapies for 1 year: the experience of an outpatient dermatological clinic for psoriasis. Clin Exp Dermatol 2014; 40:136-41. [DOI: 10.1111/ced.12504] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2014] [Indexed: 01/14/2023]
Affiliation(s)
- D. Graceffa
- Centre for the Study and Treatment of Psoriasis at the Department of Clinical Dermatology; San Gallicano Dermatologic Institute; IRCCS; 00144 Rome Italy
| | - E. Maiani
- Centre for the Study and Treatment of Psoriasis at the Department of Clinical Dermatology; San Gallicano Dermatologic Institute; IRCCS; 00144 Rome Italy
| | - I. Sperduti
- Biostatistic Division; Scientific Direction; San Gallicano Dermatologic Institute; IRCCS; 00144 Rome Italy
| | - F. Ceralli
- Department of Rheumatology; San Camillo-Forlanini Hospital; Rome Italy
| | - C. Bonifati
- Centre for the Study and Treatment of Psoriasis at the Department of Clinical Dermatology; San Gallicano Dermatologic Institute; IRCCS; 00144 Rome Italy
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Chimenti M, Esposito M, Giunta A, Graceffa D, Babino G, Teoli M, Mazzotta A, Perricone R, Chimenti S. Remission of Psoriatic Arthritis after Etanercept Discontinuation: Analysis of Patients' Clinical Characteristics Leading to Disease Relapse. Int J Immunopathol Pharmacol 2013; 26:833-8. [DOI: 10.1177/039463201302600333] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Psoriatic arthritis is a chronic, inflammatory, disabling arthritis affecting up to 30% of psoriatic patients. Recently, it has been demonstrated that tumor necrosis factor alpha (TNF-α) plays a pivotal role in inducing and maintaining joint damage and that molecules that block this cytokine are effective in the treatment of psoriatic arthritis. Etanercept is a recombinant fusion protein acting as a competitive inhibitor of TNF-α, and numerous clinical trials have demonstrated its efficacy in determining psoriatic arthritis remission. However, specific criteria defining psoriatic arthritis remission have not been delineated and few data describing the length of the remission after etanercept discontinuation are available. The aim of this observational, retrospective study was to assess post-remission efficacy maintenance and relapse characteristics after etanercept interruption in patients with moderate-to-severe peripheral psoriatic arthritis (PsA) and cutaneous involvement.
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Affiliation(s)
- M.S. Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Internal Medicine, Unit of Rheumatology, University of Rome Tor Vergata, Rome Italy
| | - M. Esposito
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A. Giunta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - D. Graceffa
- Rheumatology, Allergology and Clinical Immunology, Department of Internal Medicine, Unit of Rheumatology, University of Rome Tor Vergata, Rome Italy
| | - G. Babino
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - M. Teoli
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A. Mazzotta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - R. Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of Internal Medicine, Unit of Rheumatology, University of Rome Tor Vergata, Rome Italy
| | - S. Chimenti
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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Chimenti MS, Perricone C, Graceffa D, Di Muzio G, Ballanti E, Guarino MD, Conigliaro P, Greco E, Kroegler B, Perricone R. Complement system in psoriatic arthritis: a useful marker in response prediction and monitoring of anti-TNF treatment. Clin Exp Rheumatol 2012; 30:23-30. [PMID: 22260811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 07/08/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Treatment with anti-TNF agents is well established in psoriatic arthritis (PsA). Anti-TNF agents are capable of modulating complement activity in vitro but there are no data on the in vivo effect. Anti-TNF have high costs and potential risks, thus, there is an urgent need for accurate predictors of response. We aimed at studying the usefulness of erythrocyte-sedimentation-rate (ESR), C-reactive protein (CRP), and complement for response prediction and monitoring of anti-TNF treatment in PsA patients. METHODS Fifty-five patients were included consecutively before starting etanercept or adalimumab. ESR, CRP, plasma complement C3, C4, and C3 and B cleavage fragments were evaluated at baseline and after 22 weeks of anti-TNF treatment. Disease activity was measured with DAS28 and response to therapy with EULAR criteria. Complement was evaluated at baseline in 30 healthy subjects as well. RESULTS At baseline, C3 and C4 levels were significantly higher than in controls (C3 126.9±22 vs. 110±25 mg/dl, p=0.000002; C4 31.2±9.2 vs. 22.7±8.3 mg/dl, p=0.0003). After anti-TNF therapy, C3 and C4 levels were significantly reduced to normalization (p=0.0009 and 0.0005, respectively) and ESR, CRP and DAS28 showed a significant reduction (p=0.002, 0.004 and 0.0001, respectively). Split products of C3 and B were not observed at baseline and after 22 weeks. Higher baseline C3 levels were associated with EULAR non-response (p=0.011). CONCLUSIONS PsA patients with moderate to severe disease show elevated C3 and C4 levels, reverted by anti-TNF treatment. High C3 may be considered a hallmark of inflammation and C3 revealed the highest predictive value for response to anti-TNF.
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Affiliation(s)
- M S Chimenti
- Allergology, Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy
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Valeriani M, Galli F, Tarantino S, Graceffa D, Pignata E, Miliucci R, Biondi G, Tozzi A, Vigevano F, Guidetti V. Correlation Between Abnormal Brain Excitability and Emotional Symptomatology in Paediatric Migraine. Cephalalgia 2009; 29:204-13. [DOI: 10.1111/j.1468-2982.2008.01708.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We investigated a possible correlation between brain excitability in children with migraine and tension-type headache (TTH) and their behavioural symptomatology, assessed by using the Child Behaviour Checklist (CBCL). The mismatch negativity (MMN) and P300 response were recorded in three successive blocks to test the amplitude reduction of each response from the first to the third block (habituation). MMN and P300 habituation was significantly lower in migraineurs and TTH children than in control subjects (two-way ANOVA: P < 0.05). In migraineurs, but not in TTH patients, significant positive correlations between the P300 habituation deficit and the CBCL scores were found ( P < 0.05), meaning that the migraineurs with the most reduced habituation showed also the worst behavioural symptomatology. To the best of our knowledge, this is the first study showing a correlation between neurophysiological abnormality and emotional symptomatology in migraine, suggesting a role of the latter in producing the migrainous phenotype.
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Affiliation(s)
- M Valeriani
- Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - F Galli
- Faculty of Psychology 1, University of Rome ‘La Sapienza’, Rome, Italy
| | - S Tarantino
- Division of Paediatric Psychology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - D Graceffa
- Faculty of Psychology 1, University of Rome ‘La Sapienza’, Rome, Italy
| | - E Pignata
- Faculty of Psychology 1, University of Rome ‘La Sapienza’, Rome, Italy
| | - R Miliucci
- Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - G Biondi
- Division of Paediatric Psychology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - A Tozzi
- Epidemiology Unit, Ospedale Pediatrico Bambino Gesù IRCCS
| | - F Vigevano
- Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - V Guidetti
- Department of Child and Adolescent Neurology and Psychiatry, University of Rome ‘La Sapienza’, Rome, Italy
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Graceffa C, Giorgianni C, Raimondi M, Graceffa D, D'Arrigo G, Abbate C. [Carpal tunnel syndrome among cashiers in commercial businesses]. G Ital Med Lav Ergon 2006; 28:187-8. [PMID: 16805458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The Check-out assistants represent a working sector at risk of Work Related Musculo Skeletal Disorders (WMSDs). The aim of our study is to evaluate carpal tunnel syndrome's incidence in check out assistants. Our search was carried out on a sample of 695 female check-out assistants,after a specific risk's valutazion witch "chec-list application", during health surveillance. Subjects with an pand's painful symptoms or paraesthesias along territory of median were submitted to tests thath revial compression of median at wrist: Phalen and Tinel tests. Who were positive to painful symptoms or paraesthesias in both tests, were subjected to electromyographia (E.M.G.), gold standard for carpal tunnel Syndrome diagnosis. This sample was compared with a control group no-exposed to specific risk (all teachers) of equal number, age, sex and working age of our sample. Our results point out that: our study sample show more symptoms and carpal tunnel Syndrome than the control group; tere aren't statistically meaningful differences between test's positive subjects amd EMG positive subjects. We demonstrated that a careful anamnesis and objective exam can replace EMG.
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Affiliation(s)
- C Graceffa
- Dip di Medicina Sociale e del Territorio Università di Messina, Sez Medicina del Lavoro, Italy
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